What is insomnia?
Ok, so first off let's start off with what you might think is the most basic and easiest question to answer, what is insomnia?
Well, of course, it’s, an inability to sleep, but let's see how this question and the scientific and medical understanding around this question has developed.
There are many definitions of insomnia on the web as well as sources dating back to the 1600’s as to its first use. Related words are agrypnotic and agrupnos meaning wakeful from the pursuit of sleep.
For a definition go to https://en.wikipedia.org/wiki/Insomnia
Full definition and criteria are found here DSM-IV-TR Diagnostic Criteria for Primary Insomnia
Ok well, those are sources of definitions of the words but what are the medical and scientific understandings in more detail.
Now let’s get a bit more Scientific
Why is the science important in our understanding of insomnia? Well, the science is important because science can go a long way to treating and helping us live with and understand our insomnia. It’s not the only source of information, understanding or treatment but is an important part.
Some scientific history of diagnosis:
In the 1980’s insomnia was defined as a symptom of but not a primary disorder. A symptom of other disorders such as depression or other mental or physical primary disorder.
The treatment for this was to either focus on the primary disorder and hope that insomnia will sort itself out by sorting out the main disorder or to ignore insomnia as of no primary concern or if treated use hypnotics as a short-term treatment.
Chronic insomnia was defined as occurring only as part of another psychological or physical illness.
Author's side note: this probably goes some way to explaining why as we grew up and as an when we talked about or heard others talk about the fact they can't sleep or we have insomnia the usual response was “why what's on your mind?” or “you must be depressed” and so on. If the doctors, psychologists and scientist were thinking along these lines back then-then it would no doubt filter down into society through the media.
Around about 2005 this viewpoint and understanding within the scientific community changed somewhat (I have mentioned this in a previous blog post but as this is becoming part of what is hoped to be a continuing series in 2016 it's worth going back over).
In 2005, insomnia changed from being classed as a symptom to being classed as a disorder in its own right. It was seen to be typically combined with other disorders or illnesses but this is an important change in classification.
It was now acknowledged that chronic insomnia did indeed exist and it in itself should be treated. Whether seen in conjunction with another disorder or not.
Author’s side note: this should have been a sigh of relief for those of us who have lived with insomnia for a number of years and had become convinced that there must be something psychologically or physiologically wrong with us other than insomnia because well society was telling us so. I remember many a time thinking “well I don’t feel depressed or ill but I must be, everyone keeps telling me so, maybe I just can't see it”. As insomniacs, we all know how the internal dialogue of “why can’t I sleep?” or “I hope I can get some sleep tonight” becomes the thing that will keep us awake in a vicious spiralling circle.
Treatment was from that point on, in 2005, focused on both insomnia and the illness or disorder itself. Often finding that treating insomnia helped treat the illness or disorder.
In 2014, DSM-IV-TR stated used to diagnose insomnia said it is that the predominant complaint is difficulty initiating or maintaining sleep, or nonrestorative sleep, for at least 1 month.
This is important because now not only does it become a disorder in its own right but it has the criteria for diagnosis. This is not important so you can tell everyone you have the diagnosable disorder but more importantly so you have it taken seriously by your doctor and treatment be found.
It also means that we can get away from the endless nights of self-pity and torment about why we have insomnia and what can it mean and means we can move to say “I have insomnia how am I going to live with it?”. At Insomnia Life, we believe acceptance is crucial. Once you accept insomnia as part of your life you go from suffering from insomnia to living with insomnia, this is a very important change in mindset.
So now we have some understanding of diagnosing insomnia and its meaning in our next blog we will look into the Cause and Effect of Insomnia.
In fact, lets, not let's look a little deeper into what insomnia is and where this relatively new phenomenon came from.
Insomnia Disorder as Defined by the DSM-V
Is a “predominant complaint of dissatisfaction with sleep quantity or quality”, this is associated with either difficulty falling to sleep, staying asleep or waking up too early without being able to fall back asleep.
There are other elements of the definition that class insomnia as a disorder in its own right. Such as it causes distress in other areas of their life. Sleep distress happens more than three times a week for a period of over three months. It is not associated with any other disorder or with any medication that is being taken.
